Looking For An Ideal Mediclaim Policy Insurance Plan?

mediclaim policy

Having health insurance is essential for everyone, regardless of age. Without a mediclaim policy, a single illness can consume your funds. However, picking a suitable health plan can be challenging and complex.

Are you new to the insurance industry and looking for an ideal health insurance plan? Continue reading to find out how to select the finest health insurance option available in India. 

Here are some fantastic suggestions for selecting the most significant health insurance plan in India:

Select the proper coverage

Evaluating the coverage provided when purchasing a health insurance policy is crucial. By coverage, we imply the costs covered by your policy separately, such as surgery costs, ambulance fees, daycare costs, hospitalization costs, etc.

Consider your family’s and your mediclaim policy requirements, and choose a plan that provides the appropriate coverage. Avoid choosing a plan that offers much more coverage than you require because the premium price will go up. Instead, you can opt for riders as per your requirement, which might cost you less than a comprehensive policy with extensive coverage.

Prefer family floating plans

Instead of purchasing individual health policies for each family member, choose a family floater plan if you buy insurance for the complete unit. Personal insurance policies for every family member are significantly more expensive than family floater insurance plans. Furthermore, not everyone becomes ill at the same time. Therefore, any family member may use the sum insured accessible on a floater basis.

However, it might not be wise to include elders in the same family floater plan. It is so because the age of the eldest member of the family decides the premium amount for the floater plan. Buying a separate plan for seniors might turn out to be cheaper.

Select the appropriate sum insured

Be cautious about selecting the sum insured you need when buying medical insurance. If you choose a higher insured amount, your premium will rise. Instead, if you select a lower coverage amount than what you require, it won’t be sufficient to cover your medical expenses fully, and you’ll be required to make additional payments when your claim is settled.

Alternatively, you might choose a basic plan with a lesser sum insured and add a top-up insurance plan to your purchase. If your primary plan’s maximum coverage is reached, the top-up plan will give you additional protection.

Decide on a plan that can be renewed indefinitely.

Ensure that the plan you choose may be renewed indefinitely. This is crucial because you’ll need health insurance when you get older. However, purchasing health insurance in your later years can be challenging and expensive. You can keep the same plan when you get older if your current one has lifetime renewability.

Strive to have a high claim settlement ratio

Choose a health insurance provider with a high claim settlement ratio (CSR) before purchasing. The CSR is calculated as the proportion of total claims resolved to total claims received. As a result, a greater CSR means that there is a better probability that the insurance company will settle the claim.

Verify the hospital network listed

Pick an insurance provider with a large selection of hospitals in its network that provide cashless hospitalisation services. Also, ensure that these network hospitals are in your vicinity.

Pick plans with lower PED Waiting Period

The Pre-existing diseases waiting period is a crucial factor to consider when selecting a health plan. After the PED waiting period, the insured may submit a claim for pre-existing conditions. Depending on the plan, this period typically ranges from 2 to 4 years.

Prefer plans without co-payments or sub-limits

Check for sub-limits or co-payment provisions. Co-payment refers to the portion of the claim amount you agree to pay at claim settlement, while sub-limits refer to the coverage limit on particular covers. To avoid financial stress during claim settlement, try to choose a plan without a sub-limit or co-payment provision.

Examine multiple health plans

One of the best ways to select the finest health insurance is to compare several plans based on their perks, pricing, and coverage. You can get the plan that offers the most coverage for your money by comparing them.

Therefore, compare health insurance coverage using insurance aggregator websites to find the best deal.

Verify the insurance company’s reputation

Research the insurance provider’s reputation before choosing a health plan. Doing this might reveal more about the insurance company’s after-sale services. To have a thorough idea of the services provided, you can read reviews of Niva Bupa Health Insurance company, which is one of the best in the industry.

When searching for the ideal mediclaim or health insurance policy, there are several factors to consider to ensure you get the coverage that best suits your needs. Here are some key points to keep in mind:

  1. Coverage Type:
    • Determine whether you need individual coverage, coverage for your family, or a group plan through your employer.
    • Decide on the type of coverage: basic hospitalization, critical illness, or comprehensive coverage that includes outpatient, maternity, and other benefits.
  2. Coverage Amount:
    • Assess your medical expenses and choose a coverage amount that can adequately cover potential healthcare costs.
    • Consider factors like your age, current health status, and any pre-existing conditions.
  3. Network Hospitals:
    • Check if the insurance provider has tie-ups with a wide network of hospitals and healthcare providers.
    • Ensure that your preferred hospitals and doctors are part of the network to avail of cashless treatment.
  4. Pre-Existing Conditions:
    • Understand how pre-existing conditions are covered under the policy. Some policies have waiting periods or exclusions for certain conditions.
  5. Premium Cost:
    • Compare premium costs from different insurers. Keep in mind that lower premiums might offer less coverage or have higher deductibles.
  6. Claim Process:
    • Review the insurer’s claim settlement process. A smooth and hassle-free claims process is crucial during emergencies.
  7. Sub-limits and Co-payments:
    • Be aware of any sub-limits on specific treatments or co-payments, which are a percentage of the bill that you have to pay.
  8. Renewability:
    • Opt for policies with lifelong renewability to ensure coverage as you age.
  9. Waiting Periods:
    • Understand waiting periods for specific treatments or pre-existing conditions. Choose a policy with shorter waiting periods if possible.
  10. Additional Benefits:
    • Look for policies that offer additional benefits like maternity coverage, preventive health check-ups, and wellness programs.
  11. Exclusions:
    • Carefully read the policy’s list of exclusions to know what is not covered.
  12. Riders and Add-Ons:
    • Consider optional riders or add-ons that can enhance your coverage, such as critical illness riders or accidental coverage.
  13. Customer Service:
    • Research the insurer’s reputation for customer service, including their responsiveness and ease of communication.
  14. Policy Terms and Conditions:
    • Thoroughly read the policy document to understand all terms, conditions, and inclusions.
  15. Claim Settlement Ratio:
    • Check the insurer’s claim settlement ratio, which indicates the percentage of claims they have successfully settled.
  16. Reviews and Recommendations:
    • Seek recommendations from friends, family, or online reviews to gauge the insurer’s reputation.
  17. Tax Benefits:
    • Explore the tax benefits available under health insurance policies as per your country’s tax laws.

Remember that there is no one-size-fits-all policy, and the ideal mediclaim policy will vary depending on your unique circumstances. Take your time to compare policies, consult with insurance experts, and choose the one that provides the best balance of coverage and affordability for your needs.


Deciding to purchase health insurance is essential since it can protect you from a financial crisis in the event of an unforeseen medical expenditure. The above information will help you choose the best health insurance plan if you need help on how to proceed.

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